Inspection on 30/07/07 for Mansion House

This inspection was carried out on 30th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Mansion House 16/08/06

Mansion House 27/01/06

Mansion House 08/09/05

Mansion House 24/03/05

Mansion House 06/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Mansion House Burnham Road Althorne Maldon Essex CM3 6DR Lead Inspector A Thompson Key Unannounced Inspection 14:00 30th July & 26th November 2007 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mansion House Address Burnham Road Althorne Maldon Essex CM3 6DR 01621 742269 F/P 01621 742269 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Francis George Kirk Ms Simone Walmsley Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 36 persons) 16th August 2006 Date of last inspection Brief Description of the Service: Mansion House is a fully detached period property with the original building reported by the provider as being around 600 years old. Its location is on the eastern edge of the village of Althorne, which is approximately two miles from the nearest town of Burnham on Crouch. The original building has been considerably extended, and is registered to provide accommodation for thirty six elderly people (over the age of 65) in twenty eight single and four shared rooms. Accommodation is provided on two floors. There are four communal lounges and two communal dining rooms, all on the ground floor. Access between floors is provided by a passenger shaft lift. Mansion House is set in attractive & spacious enclosed grounds, which are accessible to residents. Ample visitor car parking is available to the front of the property. Public transport links include a bus service along the main road directly in front of the home and rail services approximately one mile away in Althorne Village. Information regarding fees is available from the home. Past inspection reports are available from the home, and from the CSCI internet website. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place on 30th July & 26th November 2007. The content of this report reflects the inspector’s findings on the day/s of the inspection along with information provided by the service and feedback by residents, relatives, staff and other parties. Practice and procedures occurring after this inspection will be reported on in future inspection reports. Discussions took place with residents, visitors, the registered manager, the deputy manager, care staff and other staff on duty. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. Six residents were spoken with and questionnaires were also left at the home for others to comment on the care provided. All who expressed an opinion confirmed that they were satisfied or very satisfied with the home and with the care and staff attitudes. Actual comments received included, ‘the staff here are very good’, ‘it’s friendly as well as efficient’ and ‘the staff could not be more helpful’. Comments on the food included, ‘the food is good and I get enough to eat’ and ‘the meals here suit me’. Those spoken to also said that they were satisfied with the quality of accommodation offered, one comment was ‘as comfortable as home’. Visitors spoken with were complimentary of the care and support provided to residents by the staff and manager. Questionnaires were also left at the home so that relatives had the opportunity to make their views on the service known to the Commission. Staff confirmed they received good support from the management team. They also confirmed that they had been provided good training opportunities, including NVQ training. Twenty eight standards were inspected and the outcomes for residents against two of these was excellent with twenty five good and one adequate. As a result there are no requirements for action identified and there is just one good practice recommendation included on page 24 of this report. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5 Quality in this outcome area is good. Admission processes ensure that residents can be confident that the home considers they can meet their needs. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The manager of the home or the deputy manager visit prospective new residents to carry out a written assessment. One assessment was inspected for a resident admitted since the last inspection. Information included headings of background information, next of kin details, medication, manual handling needs, social interests and need, general health needs, mobility, vision, hearing, diet, continence, and includes a full manual handling assessment. A separate social history record is also completed and was also seen. There was also a separate written assessment of potential pressure area risk. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 9 Prospective new residents are invited to visit Mansion House prior to deciding on a placement, to try to ensure full awareness of facilities available and providing the opportunity to meet with existing residents and staff. Lunch would be offered during these visits. Residents and visitors spoken with confirmed they were invited to visit. The homes assessment format is completed in addition to any local authority placement assessment. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Care plans had been regularly reviewed and provided up to date information on the health, personal and social care needs of residents. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Three care plan files were inspected. These contained admission information, such as next of kin, with a social history and health history. Care plans are compiled using the homes needs assessment format with daily plans of care and instructions to staff under main headings of mobility, continence, special needs, communication, personal care, mental health, pressure management, nutrition, dental, hearing, sight needs and social preferences. Individual needs are recorded with problem/need, instructions/goal and daily action required by staff. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 11 Care plans inspected had been regularly reviewed. Individual risk assessments covering identified hazard and risk rating, with the perceived consequences and measures to control the risk. These were held separately from care plan files. Separate manual handling and falls assessments had also completed. District nursing services provide tissue viability assessments and guidance/advice on continence issues. District nurses also visit the home to provide nursing services to residents, including those suffering from diabetes. The home has access to a continence nurse and an Occupational Therapist visits the home to support residents mobility needs. Chiropody, optician tests and dental services are undertaken at the home by visiting practioners. Hearing tests are available at a local hospital after referral by the GP. GP practices are provided in Burnham on Crouch and Southminster. The homes policy on the ordering, supply, administering, storage, security and disposal of medicines provided clear instructions and guidance to staff on the required procedures. Staff had been trained on medication procedures, certificates of attendance were seen. Dispensing/pharmacy services are provided by the local GP practices, Records confirmed that medication received into the home is checked in and unused returns are recorded. Medications kept in the home were considered appropriately stored and there were no gaps noted in administration records inspected. The deputy manager advised that the majority of residents had private telephone lines installed in their rooms, with the remaining residents able to use the office portable phone. Residents said that they thought they were treated with respect by staff. Observation of staff going about their duties confirmed this, and staff on duty were seen to be courteous, caring and professional in their dealings with residents. Visitors spoken with confirmed that staff were caring and professional. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. The lifestyle experienced within the home matched the expectations of residents. They were able to maintain contact with family, friends and participate in the local community. Residents were offered a varied, appealing balanced diet and were supported to exercise choice in their daily lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents meetings continue to take place, records were available for inspection. Meetings now occur approximately twice a year. Items discussed included menus, outings, activities and general day to day issues. These meetings are chaired by a resident, who then liaises with management on issues raised. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 13 Residents spoken with confirmed they were fully satisfied with the choices and options made available to them regarding daily routines and leisure interests on offer. Activities records are maintained. In-house activities are decided on each day according to group choice, a member of staff is designated to lead activities each day except Thursdays when a volunteer covers this role. Photos were on display in the home of outings arranged during the summer months. Residents had decided on the destinations. Transport was in a hired mini bus driven by a volunteer. Regular coffee mornings are held and there is a weekly visit from an organist who plays in the rear lounge. Discussions with residents confirmed that some go out with staff to garden centres, the local pub and on holidays. Some also attend local day centres once or twice a week. Two different hairdressers call to the home once a week, the mobile library calls monthly, book clubs visit monthly and a clothes shop visits occasionally. Holy Communion services are available in the home on a monthly basis by a visiting local clergywoman. Some residents are visited by their own clergy. The main meal of the day is lunch (choice available) with usually a hot or cold choice at tea. Supper snacks are available. The deputy manager advised that snacks are also available at night for residents who may be awake. Some residents choose to eat in their rooms the remaining eat in the home’s dining areas. All residents (by choice) have breakfast in their rooms. The chef confirmed that cooked breakfasts were available. A member of staff is always on duty in each dining area at mealtimes to offer assistance and support. Nutrition records and menus evidenced that a range of choices is available with appropriate nutritional content. Residents spoken with said the food was good and that there was always a choice at lunch and tea. Discussion with staff and observation confirmed that food stocks were kept at a good level. The deputy manager advised that there had been an increase in catering staff numbers to provided a cook at teatimes. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. Practices in the home safeguard residents, and ensure that concerns are listened to and addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been no recorded complaints since the last inspection. The complaints policy included information to the prospective complainant on whom to complaint too with response timescales. There were also contact details of the registration authority. A copy of the policy is included in the information provided to new residents. Residents spoken with said they knew who to speak to in the home if they any concerns. The home had a staff training video package entitled ‘abuse in the care home’. This is shown to all new staff as part of the home’s induction procedures. The home also had the latest Essex Social Services guidelines and procedures relating to adult protection and actions expected from staff under this subject. Included were recording and reporting templates and procedures along with definitions of the various recognised types of abuse. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 15 Also seen for reference were the Department of Health’s POVA and the Essex Vulnerable Adults Committee (EVAPC) booklets on abuse for staff to refer to. Records and discussion confirmed that staff had attended POVA training on adult protection. The home’s ‘whistleblowing’ statement/policy provided guidance to staff on reporting concerns. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,26 Quality in this outcome area is excellent. Furnishings in the home looked comfortable and the home appeared safe and was well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 17 Mansion House is a large detached property set in well maintained private grounds. Following inspection of the premises the inspector considered that the home is accessible and very well maintained. Some areas of individual and communal accommodation provided excellent facilities for residents. All areas seen were considered comfortable and homely. Residents have access to the grounds and several rooms also benefit from the use of small private, individual, walled and paved patio areas. Residents are able to help with the gardening, by choice (discussion with one resident confirmed this), General day to day maintenance is undertaken by the designated maintenance person. Since the last inspection the provider had erected a large summer house and a small greenhouse in the garden close by the rear lounge. There were six communal rooms available for residents, combined space met the recommended standard. Lighting in communal rooms was domestic type and appeared sufficiently bright and positioned to facilitate reading and other activities. Furnishings in communal and private rooms were also considered to be domestic in character and of good quality. There were five bathrooms in Mansion House four of which offered assisted bathing facilities including the new ‘walk-in’ shower room. All bathrooms had wc’s. There were five separate communal wc’s available in the home and twenty seven private bedrooms benefit from fitted ensuite toilets. Rooms inspected were personalised to individual tastes, naturally ventilated with windows and were centrally heated with radiators fitted with thermostatic control valves. During discussion with residents all said their rooms were comfortable and that they were able to bring in personal items when they moved to Mansion House. The homes laundry room was fitted with two washing machines both equipped with sluice cycle programmes and two tumble dryers. The laundry floor finishes were considered impermeable and readily cleanable. Policies and procedures were in place for the control of infection and include safe handling and disposal of clinical waste. Throughout the inspection the premises were considered very clean and free from any offensive odours. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Staffing levels appeared to meet the needs of residents and staff had been trained to equip them with the skills for their role. Staff recruitment procedures aimed at the protection of residents had been followed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes staffing rota was inspected and evidence staffing levels are being provided at five carers on morning shifts with four carers on afternoon shifts with a fifth carer from 1700-2200 hours. The deputy manager said that some mornings an additional carer works from 0800-1000. Two waking carers work night shifts. The manager and assistant manager’s hours remain supernumery. Staffing rotas also evidenced that separate and additional staff are employed for catering, domestic and maintenance duties. NVQ training continues to be available for staff but evidence was not seen to confirm that 50 of carers had been trained to level 2 or equivalent. Staff spoken with did confirm that this training was open to them. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 19 The assistant manager had the NVQ level 3 and the manager had NVQ level 4. Staff recruitment procedures were inspected. Two written references, proof of ID, application forms and CRB checks were obtained on new staff. Also seen were training records and contracts of terms & conditions of employment. Staff spoken with confirmed that they had interviews and CRB checks. The home’s induction and foundation training process was based on the Skills for Care required standards. This consisted of a workbook format (seen) consisting of four modules for induction including subjects of principles of care, records, fire & security, manual handling, health & safety, risk assessment, infection control, food hygiene, care of service users, practical care skills, care & use of equipment, needs of service users, activities, settings, specific disabilities. On completion there is a written test paper to complete and a certificate of completion to acceptable competencies is awarded. Discussions with staff and inspection of training records and certificates confirmed that they received induction training and that short course training was provided which included: Dementia awareness, dealing with challenging behaviour, medication, Parkinson’s, deaf awareness, pressure care, supervision, first aid, diabetes, bowels & catheter care, bereavement & loss, infection control, manual handling, fire safety, stroke awareness, induction & foundation, continence promotion, funeral awareness, bladder & bowel care, POVA (vulnerable adults) & medication. The manager had undertaken a Dementia ‘train the trainer’ course, which qualifies her to train staff in-house. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38 Quality in this outcome area is good. The home had been run and managed efficiently. Procedures for gaining the views of residents and relatives were in place to ensure their views were listened too. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is qualified to NVQ level 4 in Health & Social Care and had completed the Registered Managers Award (certificates seen). The home’s quality assurance system had last been fully implemented in 2007. Questionnaires had been provided to residents, relatives and other appropriate persons/agencies (ie district nurses). Twenty completed surveys had been returned, these were seen. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 21 Sections include questions on staff attitudes, staff knowledge, managers knowledge, food, cleanliness, odour control, atmosphere, entertainment, outings, residents meetings, support provided for healthcare needs, admission process, medication, keyworker system, noise levels, privacy and any other comments. A Q.A. audit and action plan had been compiled from responses received. This consisted of written summaries of identified problem areas, actions taken by whom and the date. Some residents chose to entrust their personal allowance monies to the home for safe keeping. Records of balances held and of transactions undertaken were presented for inspection and were considered to be appropriately maintained. Remaining residents retained control of their own finances. Random samples of records required to be kept were inspected. These included care plans, assessments, fire procedures, fire drills, regulation 37 notices, accident records, staff rotas, cash held for safekeeping, staff recruitment, items brought into the home, visitors, photograph of service users & medication. Staff receive regular 1-1 supervision, records were seen which included actions agreed. Staff meetings take place, minutes of these were also seen. Discussions with staff, management and inspection of records confirmed that training is provided to staff in moving and handling training, fire safety, food hygiene, first aid and basic training in infection control. The deputy manager and some records seen confirmed that fixed and portable hoists, fire alarms, fire fighting equipment, shaft passenger lift and the electrical installation supply had all been tested or serviced. The registered provider retains responsibility for ensuring that the home’s portable electrical appliances are tested annually. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 3 3 3 Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP28 Good Practice Recommendations At least 50 of care staff should be trained to NVQ level 2 or equivalent. Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Mansion House DS0000017878.V347459.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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